MEDICARE: BACK TO HEALTH FAMILY CHIROPRACTIC, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	VT982	VT
2	111NT0100X	Thermography Chiropractor	VT 982	VT
3	111N00000X	Chiropractor	VT982	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326360272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK TO HEALTH FAMILY CHIROPRACTIC, P.C.

Provider Business Mailing Address
First Line	:	387 LAKE RD STE 3
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-2268
Country	:	US
Telephone Number	:	802-527-2225
Fax Number	:	802-527-2013

Provider Business Practice Location Address
First Line	:	387 LAKE RD STE 3
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-2268
Country	:	US
Telephone Number	:	802-527-2225
Fax Number	:	802-527-2013

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MAUREEN ANN KEEFE
Credential	:	D.C.
Telephone Number	:	802-527-2225

Provider Enumeration Date	:	02/19/2010
Last Update Date	:	02/19/2010

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